Patient-controlled analgesia versus intermittent analgesia dosing

Actively involving the patient in his or her own pain management by using patient-controlled analgesia (PCA) during the postoperative period is a concept recently introduced. This method allows self-administration of small, frequent doses of an analgesic agent to maintain a state of constant pain control. We studied the relative efficacy of PCA compared with intermittent analgesic dosing in 16 male patients requiring posterolateral thoracotomy. Eight patients received intermittent doses of buprenorphine hydrochloride (0.3 mg intramuscularly every 3 to 6 hours), and eight patients were allowed to self-activate a PCA device according to a designed protocol. In the patients using PCA, a significant reduction in the postoperative pulmonary complication rate, as evidenced by radiographic findings, was noted. In addition, significantly less medication was used and postoperative fever was substantially reduced in the PCA group. We believe PCA to be a safe, effective, and beneficial pain management modality that deserves attention in the postoperative period.